The Health Consequences of Smoking:

50 Years of Progress
A Report of the Surgeon General

1964 2014
 The Grim Statistics
Between 1964 and 2014:
 Over 20 million Americans died because of smoking,
including
 2.5 million nonsmokers
 More than 100,000 babies

 Smoking is still the leading cause of preventable

disease and death in the United States.
 What We’ve Learned
The Killer Cigarette
 Smoking risks are more deadly than 50 years ago.

 Smokers inhale over 7,000 chemical

compounds.
 At least 70 CAUSE
CANCER.
 What We’ve Learned
The Killer Cigarette
 Smoking causes disease in nearly every organ.

 Secondhand smoke kills more than 41,000

nonsmokers every year.
 There is no safe level of SHS exposure and NO SAFE
CIGARETTE.
 21st Century Tobacco Use
Between 2010 and 2014 smoking caused
 Nearly half a million premature deaths a year

 More than 87% of all lung cancer deaths

 61% of all pulmonary deaths

 32% of all coronary deaths

 Smoking and Children
 Today about half of all children 3-18 years of age are
exposed regularly to cigarette smoke.
 Every day over 3,200 kids try their first cigarette and
another 2,100 youth and young adults become daily
smokers.
 Nearly 9 out of 10
smokers started
before age 18.

Photo credit: Trinketsandtrash.org

 Smoking and Children
Every adult who dies early because of smoking is
replaced by two new young smokers.

If they keep smoking, at least one of the two will also

die early from smoking.
Smoking and Children
 The costs of smoking
 Annual smoking costs are more than $289 billion.
 We spend at least $132 billion in yearly medical care
for adults.
 We lose at least $157 billion yearly in productivity
costs when smokers get sick and die early.
 The Power of Nicotine Addiction
 Nicotine is the primary addicting drug in cigarettes.
 Nicotine keeps people smoking longer and that
causes more damage to the body
 Nicotine patches and gum,

are safe when used as

directed
 Nicotine
 Nicotine is the primary addicting drug in cigarettes.
 It can raise heart rate and blood pressure.
 It can result in premature births and low birth weight
babies in women who smoke during pregnancy.
 It can be harmful to developing brains.
 Smoking and Lung Cancer
 Today’s smokers are more likely to develop lung
cancer than smokers 50 years ago.
 Lung cancer is the #1 cause of cancer death for men
and women.
 Nearly 9 out of 10 lung cancers are caused by
smoking.
 Smoking – The Cancer Trigger
Smoking is now known to cause
13 different types of cancer—
almost everywhere in the body.
 1 out of 3 U.S. cancer deaths
are tobacco-related.
 New Cancer Findings
TWO more cancers are caused by smoking:
 Liver cancer

 Colorectal cancer –
the second deadliest
behind lung cancer

SMOKING keeps cancer

treatments from working
as well as they should.
 Smoking – The Breath Blocker
 COPD rates have risen steadily since 1964.
 Nearly 8 out of 10 COPD deaths are from smoking.
 COPD patients have higher risk for lung cancer and
heart disease.
 Women who smoke are now dying from COPD in the
same numbers as men who smoke.
 Smoking – The Breath Blocker
Chronic Obstructive Pulmonary Disease (COPD)

 Smoking causes most

cases of COPD.
 There is NO CURE for COPD
 Smoking – The Breath Blocker
Other respiratory diseases
 Smokers have a higher risk of getting and dying
from TB.
 Youth who smoke may be more likely to develop
asthma.
 Children exposed to SHS have more respiratory
infections.
 Smoking – The Heart Stopper
Cardiovascular Disease (CVD)
 CVD is the biggest killer in the U.S.

 It causes more than 800,000 deaths every

year.
 Smoking is a major cause of CVD.

 SHS increases the risk for heart attack or stroke,

even for nonsmokers.
 Cardiovascular disease includes:
 Coronary heart disease
 High blood pressure
 Heart attack
 Stroke
 Abdominal aortic aneurysm
 Peripheral arterial disease
 Smoking – The Heart Stopper
 Smoking causes cells lining veins and arteries to
swell.
 Narrower arteries mean
reduced blood flow to the
heart, brain, and organs.
 Clots can block narrowed
arteries, causing heart attack,
stroke, and even sudden
death.
 Even occasional smoking
damages blood vessels.
 Smoking & Reproduction
 Smoking during pregnancy endangers moms and
babies

 More than 400,000 U.S. babies are exposed to

chemicals in cigarette smoke before birth.

 Mothers who smoke in early pregnancy are more

likely to have babies with cleft lip or cleft palate.
 Smoking and Reproduction
 Smoking can cause ectopic pregnancy, which almost
always causes the fetus to die.
 Other smoking complications
can include:
 early delivery
 low birth weight
 Smoking and Reproduction
Smoking also causes reproductive issues for men:
 Smoking can cause erectile dysfunction (ED).

 Smoking damages DNA in sperm.

 Smoking and Diabetes
Diabetes is the 7th leading cause of death in the U.S.
 Smoking causes type 2 diabetes.

 Smokers are 30-40% more likely to develop type 2

diabetes than nonsmokers.
 Smoking and Diabetes
Diabetic smokers:
 Have difficulty regulating insulin levels.

 Have higher risk of heart disease, blindness, kidney

failure, and nerve and blood
vessel damage to feet
and legs.
 Smoking and Eye Disease
 Smoking causes serious eye disease, including:
 Age-related macular degeneration (AMD)
 Cataracts
 These diseases are the most common causes of
blindness.
 Smokers are sicker longer and more often
 More than 16 million Americans suffer from at least
one disease caused by smoking.
 Smokers have more lung infections than
nonsmokers.
 Smokers are admitted to hospitals more often than
nonsmokers.
 Smokers miss more work than nonsmokers.
 Smoking and the Immune System
 Smoking harms the immune system and causes
autoimmune disorders.
 Smoking is a cause of rheumatoid arthritis (RA).
 RA treatment can be less
effective for smokers.
 Smoking Today – The Persistent Epidemic
Cigarettes cause almost all tobacco-related disease
and death.
 Smoking claims nearly 500,000 lives every year.

 More than 16 million people have at least one

smoking-related disease.
 88 million Americans continue to be exposed to SHS.
 Smoking Today – The Persistent Epidemic
 Lower smoking rates have saved 8 million lives and
added about three years to average life expectancy.
 50 years after the first SG report, 18% of Americans
smoke compared to 43% in 1965.
 Today 42 million adults and 3 million middle and high
school students are smokers.
 We have made progress, but there is still so much
more to do.
 Saving Millions of Lives – Doing Much More
We know what works to lower smoking rates:
 Smokefree policies in public places

 Make smoking the exception – not the norm

 Easy-to-get affordable smoking cessation treatments

 Cessation – Lifeline to a Tobacco-Free Life
 Most smokers want to quit and half already have.
 Cessation therapies improve your chances of
quitting successfully.
 Saving Millions of Lives – Doing Much More
We know what works to lower smoking rates:
 Higher prices on cigarettes and other tobacco
products
 Well-funded, continuous mass media campaigns
about the dangers of smoking
 State and community outreach, educational and
public health programs
 We Can Be Tobacco-Free

The time is NOW to begin a tobacco-free future.

We can break the cycle of sickness, disability and

death caused by smoking.

We can reduce the disease and death caused by

smoking until the scourge of the tobacco use epidemic
becomes a minor public health nuisance.
We Can Be Tobacco-Free
SECOND HAND SMOKING
 ETS -Environmental Tobacco Smoke

Side stream Smoke (SSS) + Exhaled Main Stream Smoke (EMSS)

Rev Epidemiolo. Sante Publique 2007
 ETS -Environmental Tobacco Smoke

Int. J. Environ. Public Health 2009

“Third hand smoke”
Current Opinion in Pulmonary Medicine 2011, 17: 110-115

Apnee
Bradicardie
hipotensiune
SECOND HAND SMOKE
Eur Respir J 2006; 28: 397–408
Boffeyta P. Scand Work environ health, 2002,
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Asociere intre FP la locul de munca si riscul de
adenocarcinom pulmonar OR=1.68
Cancer Epidemiol Biomarkers Prev 2005;14(5). May 2005
 Jordan RE, Cheng KK, Miller MR, et al. BMJ Open 2011

Increase exposure to second hand smoke increase the risk for COPD
ASTHMA

Passive smoking during

childhood

Adult asthma

Eur Respir J 2006; 28: 397–408

PEDIATRICS Volume 129, Number 4, April 2012
Scand J Work Environ Health 2002;28 suppl 2:41-51
BMJ Online First bmj.com, published 30 June 2004
MOTHER PASSIVE SMOKING:

premature birth

low wheight at birth

(OR=1.19)

Eur Respir J 2006; 28: 397–408

11%

WHO report on thr globaltabacco epidemic 2011

Scotia: after smoking was ban in public spaces the bar workers had a decrease in
respiratory symptoms

2 luni 1 an

Occup Environ Med 2009;66:339–346.

World Health Organization’s MPOWER
strategic package of interventions proven to
reduce tobacco use prevalence including:

• Monitor tobacco use and prevention policies

• Protect people from tobacco smoke
• Offer help to quit tobacco use
• Warn people about the dangers of tobacco
• Enforce bans on tobacco advertising,
promotion, and sponsorship
• Raise state cigarette taxes on tobacco